10/20/2010 Spitzer PM+25=58

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Re: 10/20/2010 Spitzer AMPS=76

BJ & Spitzer said:
I was observing him the entire time. He was playing with the other young adults, or relaxing near me, watching attentively, and occasionally coming over for snuggling.

I would not gauge where Spitzer's numbers are based on whether he's playing, etc. Gabby has run numbers as low as a 28 and acted just fine but I wouldn't want her to be hanging out in that neighborhood for an hour. By the time you see behavioral changes or symptoms associated with hypoglycemia, you are very likely looking at a scoop and run to the ER and a potentially life threatening situation. It's why we encourage frequent testing -- you can then control the numbers. You have been collecting data for 8 days. It's too soon to draw any firm conclusions about how Spitzer will respond to low numbers or HC food. We may have been nagging a bit last night and staying awake to wait for your updates but our goal was to keep Spitzer safe.

I really think you need to reduce Spitzer's dose so you can shoot twice a day.
 
Re: 10/20/2010 Spitzer AMPS=76

Morning BJ! Do you have the syringes with half unit measures? Sptizer might do well with a lowered dose twice each day...
does he know he is having a 12 hour holiday? :razz: Hope he has a wonderful time! :mrgreen:
 
Re: 10/20/2010 Spitzer AMPS=76

Sienne and Gabby said:
... I really think you need to reduce Spitzer's dose so you can shoot twice a day. ...

He seems to be very sensitive to the insulin. I'm going to see how he is tonight, earlier if I can't finish the day @ work.

If his BG is still < 150 on low carb food, without spiking, no insulin (hit me on the head once or twice & I catch on to anything!), plus I'll wait a couple hours & retest.

If he is over 150, maybe a skinny .5 units.

And the needles do have half unit markings ... which is in my signature.
 
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Re: 10/20/2010 Spitzer AMPS=76

Sounds like a good idea, BJ, taking Spitzer's dose down to 0.5 unit. I saw on your SS that you want to be able to shoot twice a day and you are searching to find that dose.

It's great that Spitzer may need so little insulin. Good for you!
I hope the lower dose will keep him in the greens without being so low that we all get heart attacks!
 
Re: 10/20/2010 Spitzer AMPS=76

ohmygod_smile thanks...I didn't see that...such efficiency BJ!

Here is the link to Libby's post that deals with lower preshots: viewtopic.php?f=9&t=26571
Don't know if you saw that in my post yesterday.
How is Sptizer doing today? All Ps in place?
 
Re: 10/20/2010 Spitzer AMPS=76

purring
preening
playing

didn't see him pee or poo, but his behavior seems normal -
Morning routine
- has a bite of breakfast
- lays down near me and grooms a bit
- climbs on me and schnuzzles
- goes 'n' bugs the older cats
- comes back and lies down
- repeat any or all steps in any order
 
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Re: 10/20/2010 Spitzer AMPS=76

BJ & Spitzer said:
If his BG is still < 150 on low carb food, without spiking, no insulin (hit me on the head once or twice & I catch on to anything!), plus I'll wait a couple hours & retest.

If you get a pre-shot at 150, I'd suggest posting. We can walk you through the process of what to do. It may be feasible to shoot if you are home and can monitor. It's a different scenario if you have to get out the door for the day. Waiting a couple of hours is generally too long. If you retest in 20 - 30 minutes and see a reasonable rise in numbers, you'll know that BJ's BG is on the way up or he may be surfing and in either case, depending on where the numbers are, it may be fine to shoot. Part of the issue here is that it takes about 2 hours for Lantus onset to begin. So, you are not really shooting your pre-shot number. You're actually shooting whatever number is there once onset begins. You have to anticipate. With a "perfect" curve, your pre-shot and +2 are in the same neighborhood, but not always.

Oh, and just to complicate things... You don't have an AMPS this morning. If you didn't shoot, you don't have a pre-shot number. The 76 is your +12. You just keep counting the hours from your last shot. So, if you get home at what would be your AM +6, you'd list that as your PM +18. It lets those of use who are scanning subject lines know that you didn't give a shot.
 
Re: 10/20/2010 Spitzer AMPS=76

Sienne and Gabby said:
... BJ's BG is on the way up or he may be surfing and in either case, depending on where the numbers are, it may be fine to shoot. ...


Spitzer is the cat; BJ is me ;-)

though I suppose I might check me, since I did beaucoup ice cream in the tea last night :roll:
 
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Re: 10/20/2010 Spitzer AMPS=76

It does seem reasonable to me to lower the dose down to a skinny 0.5u, and see if that is low enough to be able to shoot twice a day. That sounds like a good plan, since the 1.0u is obviously too high and I'm not convinced that 0.75u will be low enough either. Some cats only need a very tiny dose to get a big response.

In this case, skipping the shot was a good idea not only because Spitzer's BG was too low to shoot, but because the 1.0u dose is too high, and you want to drain some insulin from the shed before resuming at a lower dose. But you really don't want to be forced to skip shots routinely if you can avoid it, it can cause a loss in momentum and wonky numbers. I know you understand you want to shoot twice a day, I just wanted to explain why skipping in this case was good for two reasons, IMO. You are going about this backwards, working your way down instead of up, and it makes it more difficult to gauge what dose Spitzer needs....the shed complicates things. You will need to be patient with the new dose, unless he throws some low numbers at you again.

As Sienne said, if you get a PS below 150 tonight, post and let us know. Sometimes just stalling 15-30 minutes makes a big difference, so re-testing every 15 minutes without feeding is SOP in that case. I know Spitzer free feeds, but if you can pick up his food from two hours prior to PS (if you're home) and not feed until you are ready to shoot, that is preferable so you get a "clean" PS reading without food influencing the numbers.

On the other hand, if you see a very high number tonight, please don't shoot a higher dose because the PS number is high! It is likely that Spitzer will bounce from the low numbers, and the bounce combined with no insulin may result in a very high number. Please stick to the plan and shoot Sk0.5u...the bounce will clear on it's own, you don't want to respond to it. If you do, you will likely end up in a yo-yo pattern....very high alternating with very low BG....not what you want and will only delay progress.
Worse case scenario is when you over fill the shed/insulin depot... get very low numbers... then empty out shed by dropping dose too much... or having to skip the shot. Then you'll see high numbers from the combo of the effects of rebound and an empty storage shed/insulin depot. Most react by bumping the dose back up which overfills the shed/depot again resulting in a roller coaster ride to nowhere. Not the way to work this insulin.

Above is from the sticky on the Storage Shed http://felinediabetes.com/FDMB/viewtopi ... 50&start=0

It's great that you are thinking for yourself....just please bounce stuff off us, there is a wealth of experience here that can help you shorten your learning curve. We want to help you help Spitzer.
 
Re: 10/20/2010 Spitzer PM+12=76

I caught the whole shed thing, which is why I didn't elevate on the 18th when he was up in the 200-300s; I knew he was working off the previous nights carb addition and it would just take time for the Lantus to take care of it. And it did.

Insulin for 3.5 weeks so far.
Home testing 1 week ... and radically dropping the dose from what the vet prescribed. Its amazing Spitzer has actually survived it, to be perfectly honest.
 
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Re: 10/20/2010 Spitzer PM+12=76

Great, glad you were aware of it! It never hurts to remind, and you never know who else may be reading these threads so it may help someone else too. ;-)

I won't lie, I've been very concerned about Spitzer through this process...you've been very lucky. I hope the dose reduction works well for him!
 
Re: 10/20/2010 Spitzer PM+12=76

BJM said:
purring
preening
playing

didn't see him pee or poo, but his behavior seems normal -
Morning routine
- has a bite of breakfast
- lays down near me and grooms a bit
- climbs on me and schnuzzles
- goes 'n' bugs the older cats
- comes back and lies down
- repeat any or all steps in any order
Great WCR.

Question, why do you want to go all the way down to a skinny.5u? According to your SS, 1u is the lowest you have tried so far. Half unit changes are usually used for high doses, .75u would be the next step, then .5 or even a couple of shaves in between. If Spitzer is very carb sensitive even a drop change can make a big difference, especially when you are also dealing with an emptied shed. Besides, the skinny and fat doses are a lot harder to draw consistently.
 
Re: 10/20/2010 Spitzer PM+12=76

Ann & Tess said:
Question, why do you want to go all the way down to a skinny.5u? According to your SS, 1u is the lowest you have tried so far. Half unit changes are usually used for high doses, .75u would be the next step, then .5 or even a couple of shaves in between. If Spitzer is very carb sensitive even a drop change can make a big difference, especially when you are also dealing with an emptied shed. Besides, the skinny and fat doses are a lot harder to draw consistently.

Hi Ann. I believe the new plan for the 0.5u dose is because... as Laurie/Mr. Tinkles explained:
Laurie and Mr Tinkles said:
.... going about this backwards, working your way down instead of up, and it makes it more difficult to gauge what dose Spitzer needs....the shed complicates things.

If this was a 'normal' going down the dosing ladder case, then yes, dropping by .25 increments is usually recommended.
But in this case Spitzer's beginning dose was way too high and BJ and Spitzer are trying to work it all out.

So think of it more as they are trying to find the best dose to start and go up if needed. A reset, a do-over.
Kind of like when I started with BigMac on an (over)dose of 5units. I didn't drop down by .25u.... I started over at 0.5u - worked up and then back down the dosing ladder.

Then when the best dose is found, they can take regular dose reductions all the way to OTJ... anti-jinx! :lol:
 
Re: 10/20/2010 Spitzer PM+12=76

Ann & Tess said:
...Question, why do you want to go all the way down to a skinny.5u? According to your SS, 1u is the lowest you have tried so far. Half unit changes are usually used for high doses, .75u would be the next step, then .5 or even a couple of shaves in between. If Spitzer is very carb sensitive even a drop change can make a big difference, especially when you are also dealing with an emptied shed. ...
To me, he seems insulin sensitive. The switch to the low carb diet seems to have so drastically dropped his insulin requirements that I want to be definitive in dropping it and get it somewhere lower than he needs bid.

I'm going to edit the color rules so that 40-49 isn't green. The general response to that range is concern.
 
Re: 10/20/2010 Spitzer PM+22=49

+22 = 49 gave him some high calorie canned food, plus 10 pellets of dry after the BG test.

The insulin holiday is likely to continue, at this rate.

He's tired of eating the Friskies Poultry Platter; I need to go pick up some other foods that'll interest him.

And I'll keep checking him, now that I'm home
 
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Re: 10/20/2010 Spitzer PM+22=49

bj...this is great! you have a good sense of humor, and spitzer has a holiday...

i'm no help with advice...but i'm dying to know about the ice cream in the tea thing!

(yeah...i know...i got weird priorities)

celi & binks
 
Re: 10/20/2010 Spitzer PM+22=49

Sorry for the confusion -- I really did know that Spitzer is your cat!!

Here's what I would have done rather than feed carbs so close to PMPS. I would have re-tested in 15 - 20 min. If numbers were going lower, then I would have given a small amount of gravy and re-tested in another 15 - 20 min. I really don't ever use dry food. It doesn't raise BG levels as quickly as you need it too if your purpose is to get numbers up in a hurry and the stuff sticks around in the system forever. HC gravy is in and out.
 
Re: 10/20/2010 Spitzer PM+22=49

mybuddybinks said:
...but i'm dying to know about the ice cream in the tea thing! ...

It is like using a very heavy, flavored cream

I had Constant Comment (orange spice) with Breyer's Heath Bar ice cream. Takes about 1 cup of the ice cream to 1 cup of hot beverage so that it is somewhat sweet. The result is kind of like a hot milkshake.
 
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Re: 10/20/2010 Spitzer PM+23=49

+23 = 49 too
Gave another 10 pellets of dry.

The food earlier was some AD plus the canned, plus warming it up to make it stinky and interest him in eating.
 
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Re: 10/20/2010 Spitzer PM+22=49

wow, amazing numbers!

After seeing these 49s at +22 and +23, I think Spitzer might need another cycle to empty his shed, then a restart at a lower dose.

eta: also, this seems like a stupid thing, but lots of us who study spreadsheets do use the colors to help us spot patterns. You can color the 40's to a different green if you want, but it would help me if they are still some shade of green. Seems silly, I know, it's just the way I look at cats' patterns. :-D
 
Re: 10/20/2010 Spitzer PM+23=49

Because the 40-49 range, for Spitzer, may be indicative of heading towards a hypo, I'm keeping the red, so I really see it.
 
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Re: 10/20/2010 Spitzer PM+23=49

Put down a fresh can of the Friskies Poultry Platter and didn't add any water (to avoid reducing the calorie content per volume consumed).

Spitzer is eating, so maybe I can relax a bit.
 
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Re: 10/20/2010 Spitzer PM+22=49

Libby and Lucy said:
wow, amazing numbers!

After seeing these 49s at +22 and +23, I think Spitzer might need another cycle to empty his shed, then a restart at a lower dose.
I agree with Libby, that sounds like a good plan. The holiday continues for now. :mrgreen:

BJ, I know you are concerned about the 49s and want to see those numbers rise. When you go to get some different food for Spitzer, please pick up some HC food from J&B's list so you have gravy to use for low numbers. I use 9 Lives tender slices with real beef in gravy...it has 24% carbs and plenty of gravy. In the meantime, you can use Karo mixed with a small amount of his regular food to boost his numbers up, that will work fine. The dry food really doesn't suit the purpose very well....too slow taking effect, and then takes too long to clear his system. In addition to that, it puts more stress on his pancreas if it is starting to produce insulin again, and you want to avoid that! So please, no dry food, use karo instead.
 
Personally, I agree with Libby not only about clearing the shed but about your SS. I find it really difficult to read and I look at a lot of SSs. It will be very difficult to see patterns.
 
Some people make the <50 numbers bold, to mark earned dose reductions, you could do that while keeping the green coloring....or leave the text red, but keep the green background. The background colors are important when you are looking for patterns.....
 
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